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General NPI Number Information
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NPI Number | 1730947433
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Entity Type | Organization
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Legal Business Name | MAPLE COUNSELING LLC
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Dates
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Enumeration Date | 03/08/2024
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Last Update Date | 03/08/2024
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Provider Practice Location Address
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Address Line | 5319 SW WESTGATE DR STE 241
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City | PORTLAND
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State | OR
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Zip | 97221-2432
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Country | US
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Telephone | 503-360-6656
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Fax | 866-598-4097
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Provider Business Mailing Address
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Address Line | 7810 SW GEARHART DR
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City | BEAVERTON
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State | OR
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Zip | 97007-5979
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Country | US
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Telephone | 503-360-6656
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | BENITA KATRIN MUNSON
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Credential | MS, LPC
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Telephone | 503-360-6656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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